What does this research mean for the field?

Patients with hyperkinetic borderline essential hypertension exhibit hyperreactivity of beta-adrenergic receptors, demonstrated by an exaggerated plasma cAMP and heart rate response to isoproterenol compared to normotensive controls. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To determine whether abnormal hemodynamics in hyperkinetic borderline essential hypertension stem from hypersensitivity of beta-adrenergic receptors or adenylate cyclase activation.

June 1, 1976Circulation Research

Plasma cyclic adenosine 3':5'-monophosphate response to isoproterenol and glucagon in hyperkinetic borderline (labile) hypertension.

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Why the study?

Does isoproterenol and glucagon infusion reveal hyperresponsiveness of beta-adrenergic receptors in patients with hyperkinetic borderline essential hypertension compared to controls?

Key Points

To determine whether abnormal hemodynamics in hyperkinetic borderline essential hypertension stem from hypersensitivity of beta-adrenergic receptors or adenylate cyclase activation.
Infused isoproterenol (20 ng/kg/min for 30 minutes) and glucagon (200 ng/kg/min) into 14 patients with hyperkinetic borderline essential hypertension and 13 control subjects.
Assessed hemodynamic parameters and plasma cAMP levels before and after beta-adrenergic receptor blockade with propranolol.
Isoproterenol produced a significantly higher elevation in plasma cAMP and heart rate and a smaller decrease in diastolic blood pressure in hypertensive patients compared with controls.
Plasma cAMP and heart rate increases correlated positively across all participants, and propranolol abolished the humoral and hemodynamic responses to isoproterenol in both groups.
Glucagon-induced plasma cAMP increases were slightly lower in hypertensive patients than controls and remained uninhibited by propranolol.

Structured PICO

Does isoproterenol and glucagon infusion reveal hyperresponsiveness of beta-adrenergic receptors in patients with hyperkinetic borderline essential hypertension compared to controls?

Population

14 patients with the hyperkinetic form of borderline (labile) essential hypertension (BEH) and 13 control subjects (total n=27).

Intervention

Infusion of isoproterenol (20 ng/kg per min) and glucagon (200 ng/kg per min) before and after propranolol administration.

Comparator

13 control subjects receiving the same infusions.

Outcome

Changes in plasma cyclic adenosine 3':5'-monophosphate (cAMP), heart rate, and diastolic blood pressure after 30 minutes of infusion.surrogate

Patients with hyperkinetic borderline essential hypertension exhibit hyperreactivity of beta-adrenergic receptors or adenylate cyclase, as evidenced by exaggerated cAMP and heart rate responses to isoproterenol.

Discussion

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Implication

May support beta-adrenergic hyperresponsiveness in hyperkinetic BEH; hypothesis-generating and should not yet change practice.

Cite This Study

Messerli et al. (1976) studied this question.

synapsesocial.com/papers/6a14ae27fc9ca4e5c9a60197 https://doi.org/10.1161/01.res.38.6.42

Topics

Hypertension management

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Plasma cyclic adenosine 3':5'-monophosphate response to isoproterenol and glucagon in hyperkinetic borderline (labile) hypertension.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Plasma cyclic adenosine 3':5'-monophosphate response to isoproterenol and glucagon in hyperkinetic borderline (labile) hypertension.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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Topics

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